Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $112.26 / $343.89	Facility		$111.15	$112.26	$343.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $112.26	Professional		$111.15	$111.15	$112.26
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $94.89 / $111.15 / $8,639.91	Facility		$94.89	$111.15	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Professional		$111.15	$111.15	$111.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Facility		$111.15	$111.15	$111.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $120.59	Professional		$111.15	$111.15	$120.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $94.48 / $111.15 / $141.97	Professional		$94.48	$111.15	$141.97
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $131.56 / $343.89	Facility		$111.15	$131.56	$343.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $131.56	Professional		$111.15	$111.15	$131.56
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $104.86 / $111.15 / $111.15	Facility		$104.86	$111.15	$111.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $141.56	Professional		$111.15	$111.15	$141.56
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $317.22 / $317.22 / $368.09	Facility		$317.22	$317.22	$368.09
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $317.22 / $317.22 / $368.09	Professional		$317.22	$317.22	$368.09
United Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $166.73	Professional		$111.15	$111.15	$166.73